Editorial issue 233
Learn more about biomarkers in acute kidney injury
In the 233th issue of NDT-E you will find three CME lectures presented at the ERA-EDTA meeting in Prague June 2011. In the first lecture Dr.Bruce A. Molitoris, Indianapolis, USA presents a lecture entitled “THINKING THROUGH THE BIOMARKER DILEMMA”. The second talk is entitled ”NGAL – A BIOMARKER FOR AKI AND OTHER SYSTEMIC CONDITIONS” and is presented by Dr. Sachin Soni, Aurangabad, India. He concludes that as NGAL is an early and sensitive biomarker of AKI that predicts severity and outcome this biomarker has the potential to guide therapeutic interventions trials. The third talk from this AKI symposium is simply entitled ”KIM-1” and is presented by Dr. Orfeas Liangos, Coburg, Germany. The conclusion of this talk is that KIM-1, which is a recently discovered transmembrane protein that is undetectable in normal renal tissue, is rapidly and intensely expressed followoing renal injury. Thus, discovery of the function of KIM-1 may offer novel future therapeutic options.
In this issue of NDT-E you will also find five novel interesting papers to read. In the first paper published in Kidney Int, Hiddo Lambers Heerspinket al. show that treatment effects of angiotensin receptor blockers compared with non-renin–angiotensin–aldosterone system therapy on renal and cardiovascular outcomes were greater in patients with type-2 diabetic nephropathy with lower rather than higher dietary sodium intake. Thus, their study underscores the avoidance of excessive sodium intake, particularly in type-2 diabetic patients receiving angiotensin receptor blockers. The interesting findings of this original investigation is commented in an editorial David M Charytan and John P Forman. In a third article published in Kidney Int Keiji Kono et al. show that as renal function decreased the plaque composition of coronary culprit lesions changed from necrotic core-rich to extensively calcium-rich plaques. Their finding suggests that such coronary culprit composition was associated with stability, particularly in advanced CKD. In an interesting study published in Nephrol Dial Transpl Nosratola Vaziri et al. show that in uremic rats there is a depletion of the key protein constituents of the colonic tight junction. This phenomenon can account for the impaired intestinal barrier function and contribute to the systemic inflammation in CKD. Finally, in a study published in Nephrol Dial Transpl Hajeong Lee et al. evaluated the correlation between serum phosphorus and low-grade albuminuria in 8,953 South-korean subjects and reported that higher serum phosphorus was independently related to low-grade albuminuria in individuals without evidence of renal dysfunction. Subgroup analyses showed that this association was maintained irrespective of age, gender, presence of hypertension or diabetes, body mass index and eGFR.
Please also answer the new nutritional survey. NDT-E has already received more than 620 answers to these rather difficult questions. Correct answers and comments from the authors will be posted on NDT-E when the survey is closed.
Enjoy NDT-E and your summer vacation!
Peter Stenvinkel, Editor-in-chief NDT-Educational